Coumadin Level of 9.5

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In the of the man who died of liver failure 29 days after having a normal liver function test, he received 60 units of blood and blood products such as fresh frozen plasma. He was not in the Podunk, Iowa hospital either - it is a name that everyone in the US (and probably many citizens of other countries) would instantly recognize as a world leader in medical care. My point is that if this is what happened, then there was nothing that anyone could have done that would have saved her.

Note to Iowans: Don't e-mail me for knocking Iowa. I am a University of Iowa graduate. I know that Podunk is too small to have a hospital. The place where this happened was NOT the University of Iowa Hospital and Clinics.
 
sorry for your loss

sorry for your loss

So sorry to hear of your loss. Liver function or lack of can have drastic resuts in a person's INR level. During my father's last 3 weeks before passing they had to discontinue his coumadin and without even being on coumadin his INR ranged from 4.5-6.5 because of end stage liver failure. This was all most likely brought on because of his stroke and heart disease.

Take Al's advice and make sure you get all of the facts together and try and look at them from a 3rd party perspective before getting involved in legal action. Believe me when I tell you that the legal process in medical malpractice is very involved and stressfull. Our case has been going on know for 2 years and 10 months and can turn your world upside down. If you do persue legal action make sure you understand the process and are prepared for a long haul.

Keep in mind that medical negligence does not constitue medical malpractice.
A physician can be negligent but if no harm occurs from his/her negligence then no malpractice. In other words, somebody was negligent in not contacting your mother asap about the high INR but if the cause of your mother's death was due to liver failure not related to coumadin management then no harm no foul.

Best wishes and God Bless
 
Terri,
I am so sorry for your loss. I know how hard it is on you, and from experience I do understand the need to know what happened. But in the process of trying to find out what happened, do not forget that you need to look after yourself.

Please keep us also posted on what you are doing address your BAV and an aneurysm.

Take care of yourself and God Bless.
 
Terri mentions her aortic aneurysm has gone from 4. 3 to 4.9 cm in 4 months. Several sources, including the Aortic Surgery Program web page at Cedars-Sinai, mention that the growth rate of the aneurysm is one of the considerations for surgery, and that a change of .5 cm (or more) in 6 months or 1 cm (or more) in a year is a concern. Assuming the measurements were done correctly, Terri's aneurysm has grown .6 cm in just four months. This is an important factor to have assessed during any aortic surgical consults.

For Terri, I have sent you a private message!

Best wishes,
Arlyss
 
To Terri

To Terri

I am so sorry for the loss of your dear mom, I have had my level at 10.00 and they too gave me frozen plasma thank you for sharing that info with us I am impowered with knowledge now when i have problems and go to the dr i have alot of problems with coumadin again am so sorry youll be in our family prayers god bless
 
Terri-

I just read this thread and you have my sympathies on the loss of your mom.

My husband has recently passed away too. He had cardiac cirrhosis for many years. The last few months of his life, his INR became very unstable, and was high even without any Coumadin. His ammonia levels were high too, and they were at various times throughout the past few years.

He did not pass away from actual liver failure, he had failures of many organs, renal failure being primary, but the liver failure was always lurking somewhere in the background causing trouble.

Interestingly enough, his liver function tests most times were within the normal range. He did though, have Grade 1 varices in his esophagus, and portal hypertension.

Like your mom, he too had rheumatic heart disease.

The liver is such an important organ.

Again, very sorry for your loss.
 
Terri:

Let me also say, I am so sorry for your loss. It is so very difficult to loose one's mother, and your mom sounds like a peach.

I would also like to add that my husband had rheumatic fever when he was young, and now has two prosthetic valves. He is having surgery in less than two weeks, to repair (hopefully, and not replace) his tricuspid valve, and to install a pacemaker. He has flow reversal into the hepatic veins. His surgeon said "We don't want you going into liver failure....or kidney failure." His liver enzymes have been normal for the 5 years since his first open heart surgery.

I just thought it might bring you some comfort to know that rheumatic heart disease is progressive, even after repair or replacement, and that the compromised situation with the heart can affect other organs....very seriously. Thank God that today's technology, combined with medication, can prolong a rheumatic heart diseased patients life for a very very very long time.

marybeth
 
Thanks for the feedback. Knowledge is power.
I realize that my Mom's coumadin level probably did rise becasue of her liver functions.
As for me and my BAV...4.9 CM ascending aneurysm.......I'm scheduled for a 64 slice CT scan on Tuesday.
Rapid growth is the major concern. I think surgery will be eminent.
Dread the whole process.
Not sure if the BAV will be replaced or put on a hold. Surgeon said he might not know until he gets in there.

Wish me luck.
Terri:rolleyes:
 
Terri,
Sorry to hear of your loss. My pt was 9.9 last mon. the Dr. had me take vitiam k pills for 1 day. It came down to 2.8. They still don't know what caused it to shoot up like that. I am back on track down. I go for my Tee on fri. Feb.2 to see if the clots on my valve are gone.
 
Terri, I wish you the best with your CT. You have my continued prayers.
 
Terri said:
Thanks for the feedback. Knowledge is power.
I realize that my Mom's coumadin level probably did rise becasue of her liver functions.
As for me and my BAV...4.9 CM ascending aneurysm.......I'm scheduled for a 64 slice CT scan on Tuesday.
Rapid growth is the major concern. I think surgery will be eminent.
Dread the whole process.
Not sure if the BAV will be replaced or put on a hold. Surgeon said he might not know until he gets in there.

Wish me luck.
Terri:rolleyes:
Click to expand...

Terri,
If you haven't checked out Arlyss's link to the BAVD foundation, I hope you will so you can discuss replacing the valve with your surgeon. New studies have suggested that BAV replacement at the same time is beneficial.
 
64 Slice CT Scan results are in!

64 Slice CT Scan results are in!

:confused:
MRA in October showed my ascending aorta aneursym grew from 4.5 to 4.9 cm.
64 Slice CT Scan last week (prepartion for surgery now that it's growing fast) showed it to be 4.5 cm.

Who and what do I believe????
I see my cardiologist Wednesday.

I'm sooooo confused. Do I have a problem, or don't I. Do I need surgery or not. Am I in danger?

Terri :mad:
 
This is probably beyond the expertise of anyone on this site.

You need to trust your doctors. Hospitals have review boards that would come down hard on a doctor who did any unnecessary surgery, let alone one of this kind. If they say you need the surgery then there is probably a greater than 99% chance that you do.
 
Hi Terri,

You are talking about two different modalities for imaging your aorta. Of the two, the MRA is more sensitive and accurate. You said that the MRA showed a change in size, this would support that you have had more than one. If the increase in size has occurred then especially if the time course is rapid, you need surgery. The criteria for elective ascending aortic aneurysm repair try to take into account size, rate of change, location, family history and symptoms. Basically when the risk of surgery is less than any risk from rupture of the aneurysm is often calculated on the mean size or other criteria of patients that needed emergency surgery. The death rate from these situations is rather high.

The fact that the CT scan shows a smaller size is within the range of error of the test. You need to discuss your concerns about the different radiologic studies with your doctor.
 
Terri, can I suggest you start a new thread in the Heart Talk forum here. This way more people will see your questions related to your aneurysm. Some members don't look at the Anti-coagulation forum.
 
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